J&J backs new oral drug for psoriasis with head-to-head trial

USA – Johnson & Johnson (J&J) is pushing forward with its new oral IL-23 inhibitor, icotrokinra, after promising results in treating moderate-to-severe psoriasis.

The company has announced a direct comparison trial against Stelara (ustekinumab), one of its top-selling injectable treatments, in the ICONIC-ASCEND study.

The move follows strong phase 3 trial results from ICONIC-LEAD, presented at the American Academy of Dermatology (AAD) annual meeting.

This study showed that 65% of patients taking icotrokinra achieved clear or almost clear skin at 16 weeks, compared to just 8% on placebo.

At 24 weeks, the success rate rose to 74%, with half of all patients achieving completely clear skin.

J&J’s drug also outperformed Bristol-Myers Squibb’s (BMS) Sotyktu (deucravacitinib) in previous ICONIC-ADVANCE trials, strengthening its potential as a leading oral therapy.

Liza O’Dowd, J&J’s head of immunodermatology, called the results “robust”, saying they could “shift expectations” for psoriasis treatment.

For patients, icotrokinra offers a potential first-line oral therapy, removing the need for regular injections like those required for Stelara and Tremfya (guselkumab). These two injectables earned J&J US $10.36 billion and US $3.67 billion, respectively, last year.

Sotyktu, the first oral drug offering an alternative to injections, has seen moderate sales growth since its 2022 launch, generating US $246 million last year.

However, payer restrictions in the US have slowed its progress, making BMS’s original multi-billion-dollar projections uncertain.

With icotrokinra now showing stronger clinical data, J&J hopes it can outperform Sotyktu and other oral competitors.

The ICONIC-ASCEND trial will determine whether it can also beat Stelara, marking the first-ever study comparing an oral treatment directly against an injectable biologic in psoriasis.

If successful, icotrokinra could become a preferred oral option for psoriasis patients, offering convenience and strong efficacy. J&J is betting on its potential to dominate the growing oral psoriasis treatment market.